Gauthier Vincent, Holowaychuk Marie K, Kerr Carolyn L, Bersenas Alexa M E, Wood R Darren
Departments of Clinical Studies and Pathology, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.
J Vet Emerg Crit Care (San Antonio). 2014 May-Jun;24(3):251-8. doi: 10.1111/vec.12188. Epub 2014 May 5.
To compare the effects of administering equal volumes of isotonic crystalloids and synthetic colloids on hemodynamic and laboratory variables in healthy dogs and dogs with systemic inflammation.
Randomized, placebo-controlled, blinded study.
Comparative clinical research facility.
Sixteen adult purpose-bred Beagles.
Dogs were first randomized to receive either lipopolysaccharide (LPS; 5 μg/kg, IV) or an equal volume of placebo (0.9% NaCl, IV). Dogs were then randomized into 1 of 2 groups receiving fluid resuscitation with either 40 mL/kg IV isotonic crystalloid (0.9% NaCl) or synthetic colloid (tetrastarch). After a 14-day washout, the study was repeated such that dogs received the opposite treatment (LPS or placebo) and the same resuscitation fluid regimen. Vital signs (heart rate (HR), oscillometric blood pressure) were measured and blood samples were collected for PCV, total plasma protein (TPP), serum lactate concentration, and colloid osmotic pressure (COP) measurements.
Healthy (placebo) dogs had similar decreases in PCV and TPP after administration of either fluid. Tetrastarch administration was associated with a larger increase in HR, systolic blood pressure, and mean blood pressure. Dogs with systemic inflammation had similar increases in systolic blood pressure and decreases in PCV, TPP, and lactate after administration of either fluid. Tetrastarch administration caused greater immediate increase in HR and mean blood pressure compared to 0.9% NaCl. In all dogs, 0.9% NaCl administration decreased COP and tetrastarch administration increased COP.
Resuscitation with equal volumes of 0.9% NaCl and tetrastarch caused similar changes in hemodynamic and laboratory variables in dogs with LPS-induced systemic inflammation; however, larger increases in HR and blood pressure were seen within the first 2 hours following tetrastarch administration compared to 0.9% NaCl. Tetrastarch administration increased COP in all dogs, despite a decrease in TPP.
比较给予等量等渗晶体液和合成胶体液对健康犬和患有全身性炎症犬的血流动力学及实验室指标的影响。
随机、安慰剂对照、双盲研究。
比较临床研究机构。
16只成年纯种比格犬。
首先将犬随机分为两组，分别接受脂多糖（LPS；5μg/kg，静脉注射）或等量安慰剂（0.9%氯化钠，静脉注射）。然后将犬再随机分为两组，分别接受40mL/kg静脉注射等渗晶体液（0.9%氯化钠）或合成胶体液（羟乙基淀粉）进行液体复苏。经过14天的洗脱期后，重复该研究，使犬接受相反的治疗（LPS或安慰剂）以及相同的复苏液体方案。测量生命体征（心率（HR）、示波血压），并采集血样进行红细胞压积（PCV）、总血浆蛋白（TPP）、血清乳酸浓度和胶体渗透压（COP）的测定。
健康（安慰剂组）犬在给予任何一种液体后，PCV和TPP的降低情况相似。给予羟乙基淀粉后，HR、收缩压和平均血压升高幅度更大。患有全身性炎症的犬在给予任何一种液体后，收缩压升高，PCV、TPP和乳酸降低情况相似。与0.9%氯化钠相比，给予羟乙基淀粉后，HR和平均血压立即升高幅度更大。在所有犬中，给予0.9%氯化钠会降低COP，而给予羟乙基淀粉会升高COP。
对于LPS诱导的全身性炎症犬，给予等量的0.9%氯化钠和羟乙基淀粉进行复苏，在血流动力学和实验室指标方面引起的变化相似；然而，与0.9%氯化钠相比，给予羟乙基淀粉后的最初2小时内，HR和血压升高幅度更大。尽管TPP降低，但给予羟乙基淀粉使所有犬的COP升高。
